Provider Demographics
NPI:1790543874
Name:PAGE, TRINITY ANN (LMT, CMT)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:ANN
Last Name:PAGE
Suffix:
Gender:F
Credentials:LMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 ACOMA ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4029
Mailing Address - Country:US
Mailing Address - Phone:303-669-1694
Mailing Address - Fax:303-672-0893
Practice Address - Street 1:1045 ACOMA ST STE 1
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4029
Practice Address - Country:US
Practice Address - Phone:303-669-1694
Practice Address - Fax:303-672-0893
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0001145261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service